Adolescent condom use with 'casual' versus 'main' partners

What's in a name? Teen attitudes toward condom use vary by partner type

Providence, RI -- One of the main outcomes from the world AIDS conference in Toronto this month was the push for better HIV intervention methods. This week, a new study from researchers at the Bradley Hasbro Children's Research Center and Brown Medical School, finds that teen attitudes toward condom use with whom they perceive as casual sexual partners versus main partners is crucial in developing effective HIV intervention programs.

Researchers discovered that whether or not they were with a 'main' or 'casual' sexual partner, study participants had similar numbers of unprotected sex acts, despite the fact that they were more likely to use condoms with a casual partner than with someone with whom they considered a serious partner.

"Unfortunately, this reveals that teens may overestimate the safety of using condoms most of the time with a casual partner and underestimate the risk of unprotected sex with a serious partner," says lead author Celia Lescano, PhD, with the Bradley Hasbro Children's Research Center and Brown Medical School.

This study appears in the September issue of the Journal of Adolescent Health. Over thirteen hundred sexually active adolescents (between fifteen and twenty-one years of age), from Miami, Atlanta and Providence, were recruited for this study. Researchers divided them into two groups: the sixty-five percent who reported sexual activity with main partners only in the past ninety days, and the thirty-five percent who had at least one casual partner. Interestingly, the number of unprotected sex acts in the past ninety days was substantial and equivalent between the main and casual partner groups (19.2 versus 21.5, respectively).

"We can conclude that, given these high rates of unprotected sex, teens in both groups may be at risk for contracting HIV and sexually-transmitted diseases," says Lescano.

Prior studies have shown that adolescents use condoms significantly more often with casual partners (anyone you have sex with, but do not consider to be a main partner) than with main partners (someone you are serious about). Condom use, a primary method of sexual safety, has been associated with a variety of individual characteristics and attitudes, such as self-efficacy, personal beliefs, and perception of peer norms. There are also other motivations and attitudes that may shape condom use. For example, how adolescents define their partners (i.e. 'main' versus 'casual') may play a crucial role in determining their use of condoms, the authors state.

For instance, ten percent of those teens reporting having relationships with casual partners also reported living with a main partner. In addition, the authors found that teens whose main partners had negative reactions about condom use (they are uncomfortable etc.) were less likely to use condoms.

Adolescents in the 'main partner' group were more likely to be female while males were significantly more likely to report 'casual partners'. In addition, greater substance use and riskier attitudes were reported by teens in the 'casual partner' group.

HIV intervention programs that do not target adolescents' attitudes and practices related to casual sexual partners as compared to main partners may miss an opportunity to change their risk behaviors, the authors state.

"This study demonstrates the importance of understanding an adolescent's perception of partner types in order to design effective interventions," Lescano says.

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Founded in 1931, Bradley Hospital (www.bradleyhospital.org) was the nation's first psychiatric hospital operating exclusively for children. Today, it remains a premier medical institution devoted to the research and treatment of childhood psychiatric illnesses. Bradley Hospital, located in Providence, RI, is a teaching hospital for Brown Medical School and ranks in the top third of private hospitals receiving funding from the National Institutes of Health. Its research arm, the Bradley Hasbro Children's Research Center (BHCRC), brings together leading researchers in such topics as: autism, colic, childhood sleep patterns, HIV prevention, infant development, obesity, eating disorders, depression, obsessive-compulsive disorder (OCD) and juvenile firesetting. Bradley Hospital is a member of the Lifespan health system.

Last reviewed:
By John M. Grohol, Psy.D. on
21 Feb 2009
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